黄美茹,潘春红,吴尚昱

胎膜早破（PROM）是妊娠期常见的并发症之一，胎膜破裂后其屏障作用消失，易诱发组织学绒毛膜羊膜炎（HCA），HCA可增加胎儿宫内窘迫及产褥感染发生率，而HCA诊断主要是依据产后胎膜、胎盘组织病理学检查，存在诊断延迟的问题，在临床工作中难以早期识别。近年来，血清学标志物因其无创、可动态监测的优势，成为预测HCA研究的热点，本文对PROM并发HCA的相关血清学预测指标进行综述，以期进一步研究相关指标预测价值，为早期识别PROM并发HCA提供预测价值。

胎膜早破；组织学绒毛膜羊膜炎；血清学；预测

[1] 孔北华,马丁,段涛.妇产科学[M].1.人民卫生出版社,2024. [2] Aljerian K.Chorioamnionitis:Establishing a correlation between clinical and histological diagnosis[J].Indian J Pathol Microbiol, 2020,63(1):44-48. [3] Lee K N,Cho I,Im E M,et al.Plasma IGFBP-1,Fas,kallistatin,and P-selectin as predictive biomarkers of histologic chorioamnionitis and associated intra-amniotic infection in women with preterm labor[J].Am J Reprod Immunol,2023,89(1):e13645. [4] Shao X,Lv B,Xiu Y,et al.Predictive Model for Histological Chorioamnionitis Risk in Parturients with Intrapartum Fever[J].Ther Hypothermia Temp Manag,2025. [5] Lanzarone V,Polkinghorne A,Eslick G,et al.Diagnostic tests for the prediction of histological chorioamnionitis and funisitis in pregnant women with preterm premature rupture of membranes:A systematic review[J].Aust N Z J Obstet Gynaecol,2025,65(1):13-24. [6] Shi H,Sun L,Wang Z,et al.Non-invasive prediction of histologic chorioamnionitis using maternal serum markers in women with preterm prelabour rupture of membranes[J].Am J Reprod Immunol,2022,88(3):e13594. [7] Ridout A E,Horsley V,Seed P T,et al.The neutrophil-to-lymphocyte ratio:A low-cost antenatal indicator of placental chorioamnionitis in women who deliver preterm without clinical signs and symptoms of infection[J].Eur J Obstet Gynecol Reprod Biol,2023,280:34-39. [8] Balciuniene G,Kvederaite-Budre G,Gulbiniene V,et al.Neutrophil-lymphocyte ratio for the prediction of histological chorioamnionitis in cases of preterm premature rupture of membranes:a case-control study[J].BMC Pregnancy Childbirth,2021,21(1):656. [9] Hrubaru I,Motoc A,Moise M L,et al.The Predictive Role of Maternal Biological Markers and Inflammatory Scores NLR,PLR, MLR,SII,and SIRI for the Risk of Preterm Delivery[J].J Clin Med,2022,11(23). [10] 方娇宁,潘勉,张钧.血小板计数和血小板平均体积及血小板与淋巴细胞计数比值对未足月胎膜早破的预测价值分析[J].当代医学,2020,26(08):10-14. [11] Karabay G,Bayraktar B,Seyhanli Z,et al.Predictive value of inflammatory markers(NLR,PLR,MLR,SII,SIRI,PIV,IG,and MII)for latency period in Preterm premature rupture of membranes(PPROM)pregnancies[J].BMC Pregnancy Childbirth,2024,24(1):564. [12] Tokalioglu E O,Tanacan A,Agaoglu M O,et al.Aggregate index of systemic inflammation:A novel systemic inflammatory index for prediction of neonatal outcomes and chorioamnionitis in women with preterm premature rupture of membranes[J].Int J Gynaecol Obstet,2025,168(2):640-649. [13] 张蕾,李智伟,王福珍,等.外周血系统性免疫炎症指数在组织学绒毛膜羊膜炎中的诊断及不良妊娠结局的预测价值[J].实用妇产科杂志,2023,39(11):865-869. [14] 徐燕华,文敏,沈林亚.影响足月胎膜早破孕妇胎盘组织学绒毛膜羊膜炎发生的相关因素分析[J].中国妇幼保健, 2024,39(04):690-693. [15] Maul H,Kunze M,Berger R.[Current approach in preterm prelabor rupture of membranes:new definitions?Is CRP determination useful?Are alternatives in sight?][J].Gynakologe,2021,54(3):186-194. [16] Areia A L,Areia M,Mota-Pinto A.Procalcitonin in preterm rupture of membranes:a systematic review and meta-analysis[J].Arch Gynecol Obstet,2021,303(4):917-924. [17] 李昌菊,李赛男,祁文瑾,等.血清IL-6､PCT､CRP､WBC､NEU在诊断未足月胎膜早破合并亚临床绒毛膜羊膜炎中的应用[J].医学信息,2023,36(09):102-105. [18] Lagodka S,Petrucci S,Moretti M L,et al.Fetal and maternal inflammatory response in the setting of maternal intrapartum fever with and without clinical and histologic chorioamnionitis[J].Am J Obstet Gynecol MFM,2022,4(2):100539. [19] Oben A G,Johnson B M,Tita A,et al.A systematic review of biomarkers associated with maternal infection in pregnant and postpartum women[J].Int J Gynaecol Obstet,2022,157(1):42-50. [20] Balciuniene G,Gulbiniene V,Dumalakiene I,et al.Prognostic Markers for Chorioamnionitis:IL-6,TNF-alpha,and MMP-8 in Vaginally Obtained Amniotic Fluid[J].J Clin Med,2021,10(5). [21] 余淑勤,张倩,邱羽斯.胎膜早破孕妇血PCT､SAA､IL-6变化及与绒毛膜羊膜炎的关系[J].中国医学创新,2024,21(16):174-178. [22] Feduniw S,Pruc M,Ciebiera M,et al.Biomarkers for Pregnancy Latency Prediction after Preterm Premature Rupture of Membranes-A Systematic Review[J].Int J Mol Sci,2023,24(9). [23] Kim H J,Park K H,Joo E,et al.Potential of plasma inflammatory and angiogenic mediators for predicting spontaneous preterm delivery,intraamniotic infection/inflammation,and composite neonatal morbidity/mortality in women with early preterm premature rupture of membranes[J].Am J Reprod Immunol,2024,91(1):e13809.

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